A practice-based culminating experience with Texas Children's Hospital: A hospital's journey to baby-friendly status

Breastfeeding and the use of human milk are widely accepted as the most complete form of nutrition for infants. Breastfeeding is shown to be associated with many positive health outcomes for both infants and mothers. Healthy People 2000 goals to increase breastfeeding rates in the early postpartum period to 75% fell short, with only 64% of mothers meeting this objective. Lack of support from healthcare providers, and unsupportive hospital policies and practices are noted as barriers to the initiation and duration of breastfeeding. The purpose of this study was to evaluate implementation of the BFHI Ten Steps to Successful Breastfeeding at Texas Children's Hospital. ^ The Baby-Friendly Hospital Initiative (BFHI) was developed in 1991 by the World Health Organization and the United Nations Children's Fund (UNICEF) to ensure that healthcare facilities offering maternity services adhere to the Ten Steps of Successful Breastfeeding and the International Code of Marketing of Breast-Milk Substitutes, and create legislation to protect the rights of breastfeeding women. The instrument used in this study was the BFHI 100 Assessment Tool created by Dr. Laura Haiek, Director of Public Health in Monteregie, Quebec, and her staff at Health and Social Services Agency of Quebec. The BFHI 100 tool utilizes 100 different indicators of compliance with BFHI through questionnaires administered to staff and administrators, pregnant and postpartum mothers, and an observer. ^ The study concluded that although there is much room for improvement in educating breastfeeding mothers, overall, the mothers interviewed were satisfied with their level of care in regards to breastfeeding support. Areas of improvement include staff training, as some nursing staff admitted to relying on the lactation consultants to provide most of the breastfeeding education for mothers. Only a small percentage of mothers interviewed reported that their baby “roomed-in” on average of 22 hours per day during their hospital stay. Staff encouragement of the rooming-in practice will help to increase the proportion of mothers who allow their babies to room-in. The current breastfeeding policy will also need to be revised and strengthened to be compliant with the Ten Steps. Ideally, Baby-Friendly practices will become the norm after staff are trained and policy revisions are made. Staff training and acceptance of breastfeeding as optimal nutrition for infants are the most critical factors that will ultimately drive change for the organization. ^

Categorías de la filosofía política contemporánea : Gubernamentalidad y soberanía

El presente trabajo analiza las categorías utilizadas por M. Foucault para estudiar el funcionamiento del poder en las sociedades modernas: represión ("hipótesis Reich"), soberanía ("hipótesis Hobbes"), lucha, guerra, dominación ("hipótesis Nietzsche") y "gubernamentalidad". Esta última, que describe las sociedades de normalización y las sociedades de biopoder, desplaza metodológicamente a la "hipótesis Nietzsche" de "Il faut défendre la société". En este punto el trabajo de Foucault se cruza con el de G. Agamben, especialmente, con los conceptos de "vida desnuda" y del "estado de excepción". A partir de los escritos de Agamben, el presente trabajo avanza hacia esa zona que quedó singularmente en la sombra en la obra de Foucault, la relación entre "soberanía" y "vida".

Categorías de la filosofía política contemporánea : Gubernamentalidad y soberanía

El presente trabajo analiza las categorías utilizadas por M. Foucault para estudiar el funcionamiento del poder en las sociedades modernas: represión ("hipótesis Reich"), soberanía ("hipótesis Hobbes"), lucha, guerra, dominación ("hipótesis Nietzsche") y "gubernamentalidad". Esta última, que describe las sociedades de normalización y las sociedades de biopoder, desplaza metodológicamente a la "hipótesis Nietzsche" de "Il faut défendre la société". En este punto el trabajo de Foucault se cruza con el de G. Agamben, especialmente, con los conceptos de "vida desnuda" y del "estado de excepción". A partir de los escritos de Agamben, el presente trabajo avanza hacia esa zona que quedó singularmente en la sombra en la obra de Foucault, la relación entre "soberanía" y "vida".

Categorías de la filosofía política contemporánea : Gubernamentalidad y soberanía

El presente trabajo analiza las categorías utilizadas por M. Foucault para estudiar el funcionamiento del poder en las sociedades modernas: represión ("hipótesis Reich"), soberanía ("hipótesis Hobbes"), lucha, guerra, dominación ("hipótesis Nietzsche") y "gubernamentalidad". Esta última, que describe las sociedades de normalización y las sociedades de biopoder, desplaza metodológicamente a la "hipótesis Nietzsche" de "Il faut défendre la société". En este punto el trabajo de Foucault se cruza con el de G. Agamben, especialmente, con los conceptos de "vida desnuda" y del "estado de excepción". A partir de los escritos de Agamben, el presente trabajo avanza hacia esa zona que quedó singularmente en la sombra en la obra de Foucault, la relación entre "soberanía" y "vida".

Trade Coefficients and the Role of Elasticity in a Spatial CGE Model Based on the Armington Assumption

The Armington Assumption in the context of multi-regional CGE models is commonly interpreted as follows: Same commodities with different origins are imperfect substitutes for each other. In this paper, a static spatial CGE model that is compatible with this assumption and explicitly considers the transport sector and regional price differentials is formulated. Trade coefficients, which are derived endogenously from the optimization behaviors of firms and households, are shown to take the form of a potential function. To investigate how the elasticity of substitutions affects equilibrium solutions, a simpler version of the model that incorporates three regions and two sectors (besides the transport sector) is introduced. Results indicate: (1) if commodities produced in different regions are perfect substitutes, regional economies will be either autarkic or completely symmetric and (2) if they are imperfect substitutes, the impact of elasticity on the price equilibrium system as well as trade coefficients will be nonlinear and sometimes very sensitive.

Is prohibiting land reallocation enough to promote development of farmland rental markets in China?

Prohibiting land reallocation improves tenure security, but it remains unclear whether this sufficiently facilitates the development of farmland rental markets in China. To fill this gap, we investigate how farmland rental activities are influenced by full-scale land reallocation (FSLR) and partial land reallocation (PLR), which differ in scale and imposition. Employing the instrumental-variables and the difference-in-differences approaches, we find that PLR substitutes relation-specific contracting in the markets, while FSLR complements arms-length contracting. The different impacts are attributable to the difference in imposition rather than scale. These findings suggest the need for further reforms.

Application of virtual certification techniques to vehicle design and track maintenance

Virtual certification partially substitutes by computer simulations the experimental techniques required for rail vehicle certification. In this paper, several works were these techniques were used in the vehicle design and track maintenance processes are presented. Dynamic simulation of multibody systems was used to virtually apply the EN14363 standard to certify the dynamic behaviour of vehicles. The works described are: assessment of a freight bogie design adapted to meter-gauge, assessment of a railway track layout for a subway network, freight bogie design with higher speed and axle load, and processing of the data acquired by a track recording vehicle for track maintenance.

Search strategies and the automated control of plant diseases

We propose the use of the "infotaxis" search strategy as the navigation system of a robotic platform, able to search and localize infectious foci by detecting the changes in the profile of volatile organic compounds emitted by and infected plant. We builded a simple and cost effective robot platform that substitutes odour sensors in favour of light sensors and study their robustness and performance under non ideal conditions such as the exitence of obstacles due to land topology or weeds.

Orden y naturaleza en la escuela al aire libre : el colegio para la Institución Teresiana en Alicante de Rafael de la Hoz y Gerardo Olivares

"No son necesarios imponentes edificios para dar una buena educación a los niños, mucho menos en zonas de clima suave. En el pasado Filósofos y Santos acostumbraban a sentarse con sus discípulos a la sombra de un árbol, transmitiéndoles su sabiduría sin necesidad de edificaciones de hormigón armado. Pero eran grandes hombres y grandes espíritus que sabían aprovechar el universo entero como material didáctico junto a los simples recursos de su inteligencia y su fantasía". Esta tesis nace con la intención de profundizar en la investigación de los mecanismos arquitectónicos que hicieron posible en un determinado tipo de escuelas la relación entre arquitectura y naturaleza, ya se entienda ésta como paisaje natural o como paisaje artificial creado ex novo. Si desde los tiempos de Lao Tse no había sido superada su definición de Arquitectura: “Arquitectura no son cuatro paredes y un tejado, arquitectura es el ordenamiento de los espacios y el espíritu que se genera dentro”; en realidad dicha definición adolecía de una gran carencia, pues nada decía del “espacio que queda fuera”. Así lo puso de manifiesto D. Rafael de La Hoz Arderius en su discurso de ingreso a la Real Academia de San Fernando5. Hubo que esperar al inicio del siglo XX para que la Arquitectura occidental se centrara de lleno en desmaterializar el límite entre el espacio construido y el “sitio” en el que se inserta, convirtiendo éste en “lugar” habitado. El “dentro” y el “fuera” dejan de entenderse como dos realidades antagónicas para dejar paso a un espacio continuo articulado a través de fructíferas situaciones intermedias. Sin embargo, poco se ha estudiado sobre una tipología arquitectónica : la escuela al aire libre, que fue crucial en la génesis tanto de los espacios educativos, como en la conformación del espacio Moderno así entendido. Éste es por tanto el objeto de la presente Tesis, desde una doble vertiente: por un lado desde la investigación de la evolución de esta tipología en general, y más detenidamente de un caso concreto, el colegio de las Teresianas en Alicante de Rafael de La Hoz Arderius y Gerardo Olivares James. La evolución de la escuela al aire libre se aborda a través de una selección de casos de estudio que ilustran que la regeneración social que pretendía acometerse no podía limitarse sólo a los aspectos higiénicos que centraron su primera etapa, sino que era necesario también reforzar el espíritu comunitario del niño como futuro ciudadano. Por otro lado el Colegio de las Teresianas en Alicante (1964) de Rafael de La Hoz Arderius y Gerardo Olivares James se ha elegido como caso de estudio específico. Este proyecto, siendo uno de los más desconocidos de sus autores, supone la culminación de sus investigaciones en torno a la escuela al aire libre8. Rafael de La Hoz, en línea con los postulados humanistas del Realismo Biológico de Richard Neutra, advertía de la imposibilidad de abordar la ordenación del espacio si desconocemos el proceso perceptivo del ser humano, destinatario de la Arquitectura. Esta dificultad es aún mayor si cabe cuando el destinatario no es el ser humano adulto sino el niño, dada su distinta percepción del binomio “espacio-tiempo”. En este sentido el colegio de las Teresianas en Alicante es además un ejemplo cercano, el único de los incluidos en la presente Tesis del que verdaderamente se ha podido tener un conocimiento profundo tanto por el resultado de su análisis a partir de una investigación de carácter científico, como por la experiencia personal del mismo vivida desde niña, al ser antigua alumna del centro. Tanto en este ejemplo concreto como en el resto de casos analizados la metodología para lograr la educación integral del individuo, reproduciendo el mito de la caverna de Platón revisado a través del Emilio roussoniano, se fundamenta en el contacto directo con el exterior, promoviendo un nuevo modo de vida equilibrado y en armonía con la naturaleza, con uno mismo y con los demás. Desde un primer estadio en el que el espacio exterior sustituye literalmente al aula como lugar para la enseñanza, se evoluciona hacia una tipología más compleja en la que los mecanismos de proyecto habrán de fomentar la continuidad entre interior y exterior en los espacios de aprendizaje, así como reproducir en el interior del aula las ventajas del ambiente exterior evitando algunos de sus inconvenientes. Todo ello con diferentes matices según la edad del alumno y la climatología del lugar. A partir del análisis de los casos de estudio generales y del ejemplo concreto de las Teresianas, se pretende sintetizar cuales fueron los mecanismos de proyecto y los principales temas de reflexión que caracterizaron este tipo de escuelas. ABSTRACT "Imposing buildings are not necessary for children to receive a good education, even less in mild climate areas. In the past, Philosophers and Saints used to sit with their disciples in the shade of a tree, passing on their wisdom without the need of reinforced concrete buildings. But they were great men and great minds who could take advantage of the entire universe as a source of teaching material, together with their intelligence and fantasy." This thesis was undertaken with the purpose of carrying out an in depth analysis of the architectural strategies targeting certain types of schools which have a close relationship between architecture and nature. It is said that since the time of Lao Tzu his definition of architecture had not been surpassed: “architecture is not just four walls and a roof, architecture is the arrangement of the spaces and the spirit that is generated within”. But this definition suffered from a serious lack as the “space left outside” is not mentioned. This was exposed by Rafael de La Hoz Arderius in his speech of entry into the Royal Academy of San Fernando10. It was not until the early twentieth century that Western architecture would squarely focus on dematerializing the boundary between the built environment and the “site” in which it is inserted, turning it into an inhabited “place”. The “inside” and the “outside” are no longer understood as two op-posed realities, instead they make way for a continuous space articulated through fruitful in-between situations. However, little has been studied about an architectural typology: the open air school, which was a turning point in the genesis of both educational, as well as modern space. This is therefore the object of this thesis, having two perspectives. On the one hand the development of this type of school is broadly investigated; on the other hand a specific case is introduced: the school of the Teresian association of Alicante, by Rafael de La Hoz and Gerardo Olivares. The development of the open air school is approached through a selection of case studies. These illustrate that the expected social regeneration could not be limited exclusively by the hygienic aspects targeting its first stage, but it was also necessary to strengthen the community spirit of the child as a future citizen. As previously mentioned the Teresian school of Alicante (1964-1966), has been chosen as a specific case study. Despite being quite a bit less renowned than other projects by the same authors, it represents the culmination of their researches about the open air school. In line with the humanist postulates of Richard Neutra’s Biological Realism, Rafael de La Hoz warned about the inability to deal with the arrangement of space if we are unaware of the perceptive process of the human being, addressee of the architecture. This difficulty becomes greater when the addressee is not the adult human but the child, given his different perception of the binomial “space-time” relationship. In this respect the Teresian school of Alicante is in addition a closely related case study, being the only one of the mentioned cases in this thesis allowing to acquire a deep knowledge, both from the results of its analysis coming from a research of scientific nature, as well as the personal experience lived since I was a child, given that I am a former pupil. Both in this case study and in the other analyzed cases, the methodology implemented to achieve the integral education of the individual is based on the direct contact with the exterior, promoting a balanced and in harmony with nature new way of life, including oneself and the others. Thereby it replicates the Plato’s cavern myth and its roussonian review: Emilio. From the first stage in which the exterior literally substitutes the classroom as the educational space, it is evolved towards a more complex typology in which the project strategies have to promote the continuity between inside and outside learning spaces, as well as to reproduce inside the classroom the advantages of the exterior environment avoiding some of its disadvantages; thereto considering the differing matrixes involving the pupil age and the local climatology. From the analysis of the general case studies and the Teresian school, the main project strategies and elements characterizing the open air school have been synthesized.

Optimization of water procurement decisions in an irrigation district: the role of option contracts

Water supply instability is one of the main risks faced by irrigation districts and farmers. Water procurement decision optimisation is essential in order to increase supply reliability and reduce costs. Water markets, such as spot purchases or water supply option contracts, can make this decision process more flexible. We analyse the potential interest in an option contract for an irrigation district that has access to several water sources. We apply a stochastic recursive mathematical programming model to simulate the water procurement decisions of an irrigation district?s board operating in a context of water supply uncertainty in south-eastern Spain. We analyse what role different option contracts could play in securing its water supply. Results suggest that the irrigation district would be willing to accept the proposed option contract in most cases subject to realistic values of the option contract financial terms. Of nine different water sources, desalination and the option contract are the main substitutes, where the use of either depends on the contract parameters. The contract premium and optioned volume are the variables that have a greater impact on the irrigation district?s decisions. Key words: Segura Basin, stochastic recursive programming, water markets, water supply option contract, water supply risk.

A mulher sábia e a sabedoria mulher símbolos de co-inspiração Um estudo sobre a mulher em textos de Provérbios

Nos textos de Provérbios 1,20-23; 8 e 9, encontra-se o instigante símbolo da sabedoria mulher, que possui uma longa e controvertida história de interpretação. Ao analisar as ligações textuais entre estes textos e o poema de Pr 31, descobrimos que o símbolo da sabedoria mulher inspira-se na mulher da vida real, que participa corajosamente na reconstrução da história e das relações do povo de Judá, no período pós-exílico. Estas ligações desvelam uma grande valorização da mulher e sua proximidade com Deus ao apresentá- la com o poder de oferecer vida (Pr 8,35; 9,6) e de cuidá-la (Pr 31), vivenciando e transmitindo valores éticos fundamentais para as relações cotidianas da casa (Pr 1,8; 6,20; 31,2-9.26). Este símbolo carrega ainda a memória de antigos cultos realizados na casa para celebrar e garantir a vida. Embora estes rituais contivessem a memória de Deusas, eles não eram opostos ao culto de Javé, pois, dentro da dinâmica da casa, estavam inteiramente integrados na religião de Israel pela priorização da vida e pela prática da jus tiça. Esses textos de Provérbios atestam uma grande mudança na visão da mulher. A origem desta nova visão encontra-se na época do cativeiro, quando já não havia templo e nem um governo que canalizasse a organização do povo e sua luta pela libertação. A casa passa a ter funções de prover a subsistência e de transmitir as tradições religiosas do povo bíblico com a finalidade de obter a inspiração e a força necessárias para garantir o futuro. Na casa interiorana, a mulher tem autoridade e liderança, apesar dos preconceitos da sociedade patriarcal. É no pequeno espaço da casa judaíta que o movimento da sabedoria mulher situa-se, gerando relações de inclusão e de solidariedade, na época da dominação do 2º templo, com suas normas sobre a impureza.(AU)

A mulher sábia e a sabedoria mulher símbolos de co-inspiração Um estudo sobre a mulher em textos de Provérbios

Nos textos de Provérbios 1,20-23; 8 e 9, encontra-se o instigante símbolo da sabedoria mulher, que possui uma longa e controvertida história de interpretação. Ao analisar as ligações textuais entre estes textos e o poema de Pr 31, descobrimos que o símbolo da sabedoria mulher inspira-se na mulher da vida real, que participa corajosamente na reconstrução da história e das relações do povo de Judá, no período pós-exílico. Estas ligações desvelam uma grande valorização da mulher e sua proximidade com Deus ao apresentá- la com o poder de oferecer vida (Pr 8,35; 9,6) e de cuidá-la (Pr 31), vivenciando e transmitindo valores éticos fundamentais para as relações cotidianas da casa (Pr 1,8; 6,20; 31,2-9.26). Este símbolo carrega ainda a memória de antigos cultos realizados na casa para celebrar e garantir a vida. Embora estes rituais contivessem a memória de Deusas, eles não eram opostos ao culto de Javé, pois, dentro da dinâmica da casa, estavam inteiramente integrados na religião de Israel pela priorização da vida e pela prática da jus tiça. Esses textos de Provérbios atestam uma grande mudança na visão da mulher. A origem desta nova visão encontra-se na época do cativeiro, quando já não havia templo e nem um governo que canalizasse a organização do povo e sua luta pela libertação. A casa passa a ter funções de prover a subsistência e de transmitir as tradições religiosas do povo bíblico com a finalidade de obter a inspiração e a força necessárias para garantir o futuro. Na casa interiorana, a mulher tem autoridade e liderança, apesar dos preconceitos da sociedade patriarcal. É no pequeno espaço da casa judaíta que o movimento da sabedoria mulher situa-se, gerando relações de inclusão e de solidariedade, na época da dominação do 2º templo, com suas normas sobre a impureza.(AU)

Requirement of GM2 ganglioside activator for phospholipase D activation

Sequence analysis of a heat-stable protein necessary for the activation of ADP ribosylation factor-dependent phospholipase D (PLD) reveals that this protein has a structure highly homologous to the previously known GM2 ganglioside activator whose deficiency results in the AB-variant of GM2 gangliosidosis. The heat-stable activator protein indeed has the capacity to enhance enzymatic conversion of GM2 to GM3 ganglioside that is catalyzed by β-hexosaminidase A. Inversely, GM2 ganglioside activator purified separately from tissues as described earlier [Conzelmann, E. & Sandhoff, K. (1987) Methods Enzymol. 138, 792–815] stimulates ADP ribosylation factor-dependent PLD in a dose-dependent manner. At higher concentrations of ammonium sulfate, the PLD activator protein apparently substitutes for protein kinase C and phosphatidylinositol 4,5-bisphosphate, both of which are known as effective stimulators of the PLD reaction. The mechanism of action of the heat-stable PLD activator protein remains unknown.

Altered xanthophyll compositions adversely affect chlorophyll accumulation and nonphotochemical quenching in Arabidopsis mutants

Collectively, the xanthophyll class of carotenoids perform a variety of critical roles in light harvesting antenna assembly and function. The xanthophyll composition of higher plant photosystems (lutein, violaxanthin, and neoxanthin) is remarkably conserved, suggesting important functional roles for each. We have taken a molecular genetic approach in Arabidopsis toward defining the respective roles of individual xanthophylls in vivo by using a series of mutant lines that selectively eliminate and substitute a range of xanthophylls. The mutations, lut1 and lut2 (lut = lutein deficient), disrupt lutein biosynthesis. In lut2, lutein is replaced mainly by a stoichiometric increase in violaxanthin and antheraxanthin. A third mutant, aba1, accumulates normal levels of lutein and substitutes zeaxanthin for violaxanthin and neoxanthin. The lut2aba1 double mutant completely lacks lutein, violaxanthin, and neoxanthin and instead accumulates zeaxanthin. All mutants were viable in soil and had chlorophyll a/b ratios ranging from 2.9 to 3.5 and near wild-type rates of photosynthesis. However, mutants accumulating zeaxanthin exhibited a delayed greening virescent phenotype, which was most severe and often lethal when zeaxanthin was the only xanthophyll present. Chlorophyll fluorescence quenching kinetics indicated that both zeaxanthin and lutein contribute to nonphotochemical quenching; specifically, lutein contributes, directly or indirectly, to the rapid rise of nonphotochemical quenching. The results suggest that the normal complement of xanthophylls, while not essential, is required for optimal assembly and function of the light harvesting antenna in higher plants.

Human TATA-binding protein-related factor-2 (hTRF2) stably associates with hTFIIA in HeLa cells

The TATA-binding protein (TBP)-related factor TRF1, has been described in Drosophila and a related protein, TRF2, has been found in a variety of higher eukaryotes. We report that human (h)TRF2 is encoded by two mRNAs with common protein coding but distinct 5′ nontranslated regions. One mRNA is expressed ubiquitously (hTRF2-mRNA1), whereas the other (hTRF2-mRNA2) shows a restricted expression pattern and is extremely abundant in testis. In addition, we show that hTRF2 forms a stable stoichiometric complex with hTFIIA, but not with TAFs, in HeLa cells stably transfected with flag-tagged hTRF2. Neither recombinant human (rh)TRF2 nor the native flag⋅hTRF2-TFIIA complex is able to replace TBP or TFIID in basal or activated transcription from various RNA polymerase II promoters. Instead, rhTRF2, but not the flag⋅hTRF2–TFIIA complex, moderately inhibits basal or activated transcription in the presence of rhTBP or flag⋅TFIID. This effect is either completely (TBP-mediated transcription) or partially (TFIID-mediated transcription) counteracted by addition of free TFIIA. Neither rhTRF2 nor flag⋅hTRF2–TFIIA has any effect on the repression of TFIID-mediated transcription by negative cofactor-2 (NC2) and neither substitutes for TBP in RNA polymerase III-mediated transcription.